Feline ACTH Stimulation Test

Indications

Diagnosis of hypoadrenocorticism (Addison's syndrome) or iatrogenic hyperadrenocorticism.
Monitoring of patients receiving trilostane treatment for hyperadrenocorticism.
Not indicated as a screening test for naturally occurring feline hyperadrenocorticism.

Notes

In cats, it is often recommended to collect blood samples at two time points (60 and 90 min) post ACTH (tetracosactide) stimulation.
The dexamethasone suppression test (dexamethasone administered at 0.1mg/kg) is the preferred diagnostic test for feline hyperadrenocorticism because it is more sensitive than the ACTH stimulation test.
The results of the ACTH stimulation can be affected by prior glucocorticoid administration (including topical medications), stress and non-adrenal disease.
If exogenous glucocorticoids have been administered, a withdrawal period may be required before an ACTH is performed to allow normalisation of the pituitary-adrenal axis. Please contact the reference laboratory for further advice.

Protocol

ACTH (tetracosactide) is not licensed for use in cats.
Collect a baseline blood sample (1 ml in a plain/gel tube).
For feline patients receiving trilostane, collect the first sample 4-6 hours post-pill.
Administer at least 5 µg/kg of ACTH (tetracosactide) intravenously.
Collect the second and third blood samples (1 ml in a plain/gel tube) at both 60 and 90 minutes post-ACTH injection.
Ensure the samples have clotted and centrifuge the samples 30-120 minutes after collection.
For samples collected in plain tubes, please separate the serum into another plain tube (this step is not necessary for samples collected in gel tubes).
Please label all tubes with the patient's name and the time of sampling.
Please include the patient history, including drug history, on the request form.
Submit the separated serum samples and the request form to the reference laboratory (Test code FACT).
Cortisol will be measured in all three samples.

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Feline ACTH Stimulation Test

Indications

Notes

Protocol

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